Gastrointestinal disorders
Gastrointestinal disorders are common during pregnancy. Nausea and vomitting can range from mild to severe to cause dehydration and electrolyte imbalance. Heartburn and dyspepsia usually result from hormonal changes of pregnancy and from abdominal growth.
Nausea and vomitting
Nausea and vomitting are encountered in 70-85% of pregnant women. Multiple pregnancy, history of severe hiperemesis gravidarum in a previous pregnancy or in the family are predisposing factors. Severity is assessed upon length of nausea, frequency of vomitting and weight loss. Severe forms should be evaluated by a physician.
First step of treatment is prevention. Pregnant women supplied with multivitamins before pregnancy experience less nausea and vomitting during pregnancy. Frequent and small meals, avoidance of fatty meals are other preventive measures. Mild and moderate cases can be handled by oral medications such as metochlopramide and trimethobenzamide. Severe cases may require hospitalization.
Gastroesophageal reflux
Life style changes may be sufficient to decrease such symptoms. Reduction of body weight, avoidance of harmful food and frequent and small meals can reduce such symptoms. If these are not sufficient, following medications can be used with a physician's prescription: antiacids, H2 receptor antagonists, proton pump inhibitors.
Constipation
It is a common symptom of pregnancy, especially during first and third trimesters. Hormonal changes of pregnancy result in decreased gastrointestinal motility. Among preventive measures are sufficient water intake, increasing physical activity and appropriate nutrition. If symptoms persist despite preventive measures, laxatives can be used with a physician's prescription.
Depression
Depression is common among reproductive age women. Its prevalence among pregnant women is 10-20%. Psychotherapy and emotional support groups constitute first line of the treatment. Patients with a diagnosis of depression before pregnancy and patients who discontinue antidepressants at the early gestational weeks are under the risk of relapse. Paroxetin and venlafaxin should be discontinued with the diagnosis of pregnancy. Fluoxetin is the most investigated antidepressant for a possible use during pregnancy. It has been shown to be safe, even during first trimester. Other serotonin reuptake inhibitors such as sertralin, citalopram have not been investigated sufficiently and are not advised during pregnancy.
Upper respiratory tract infections and sinusitis
They are common during pregnancy. First line of treatment is prevention. The infection occurs via inhalation. Influenza is caused by viruses and antibiotherapy is not effective. Treatment is directed towards symptoms.
- Fluid intake should be increased. Fruit juices are helpful.
- If you have decreased appetite, do not force yourself for 3 big meals. Instead, you may have 6 small meals.
- Have more rest.
- Local medications should be preferred to decrease passage to the fetus.
- Serum physiologic can be used for rhinologic symptoms.
- Parasetamol can be used at every stage of pregnancy.
- Drugs such as otrivine and iliadin cause vasoconstriction and therefore may decrease blood flow to the fetus. Thus, they should not be used during pregnancy.
Follow your body temperature. If you have fever, consult your physician.
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